Alopecia Areata – hyperactivity of the hypothalamic-pituitary-adrenal axis is a myth?

Abstract

Introduction

Psychological stress is known to cause exacerbation of different skin pathologies including alopecia areata (AA). A hyperactivity of the HPA axis in patients affected by AA (AA-patients) was proposed to be a neuroendocrine response to stress. Still little is known about MSH and cortisol production in AA settings.

Aim

The aim of the study was to compare trends in a production of melanocyte-stimulating hormone (MSH) and cortisol in patients with AA-patients and healthy controls.

Material and methods

Plasma concentrations of free cortisol and MSH were measured in forty-three AA-patients (35.5±10.6 years) and thirty-seven healthy subjects (35.9±10.5 years) selected from the Dermatology Outpatient Clinic in Katowice at Silesian School of Medicine in Poland. Results were submitted to statistical analysis with W Szapiro-Wilk test and subsequently nonparametric (U Mann-Whitney test) or parametric (t-Student test) statistics were performed.

Results

Mean plasma level of MSH was 5.39 ng/ml in AA-patients and 5.71 ng/ml in healthy controls. The difference between groups was nonsignificant (p=0.435), but the control group manifested higher values of MSH (Q75=13.6 ng/ml vs Q75=5.98 ng/ml) and this tendency was especially stronger in females. AA-patients had greater mean plasma level of cortisol (157,63 ± 91.16 μg/l) than healthy controls (123.32 ± 71.28 μg/l), however the difference between them was also nonsignificant (p=0.063). No sex-dependent tendency to a greater production of cortisol was found.

Conclusions

Expectations of disturbances in production of MSH and cortisol were not fulfilled. Neither MSH nor cortisol plasma levels appear to be clearly changed in AA-patients.

This article is protected by copyright. All rights reserved.

http://ift.tt/2pWcsCS